2015 Henegar Summer Theatre Workshop Disney`s Peter Pan, Jr.

Transcription

2015 Henegar Summer Theatre Workshop Disney`s Peter Pan, Jr.
2015 Henegar Summer Theatre Workshop
Disney’s Peter Pan, Jr.
Middle School: Grades 6-9
June 15-July 10 Cost: $300
Rehearsals: Mon-Fri 9am-12pm
Performances: July 9 @ 1pm (Daycare Show), July 10 @ 7pm, July 11 @ 2pm and 7pm
Student Name _________________________________________________________________
Age ______ Current Grade ______ School _________________________________________
T-Shirt Size:
(CHILD) S M L
(ADULT) S M L XL
Address ______________________________________________________________________
City ______________________________________
Zip Code _______________
Phone (cell) __________________________ Phone (home) ____________________________
Email ________________________________________________________________________
Parent/Guardian Name(s) _______________________________________________________
Emergency Contact __________________________________ Phone ____________________
Method of Payment _____Cash
_____Check ________
VISA/MC/DISC__________________________________________Exp_______CVV______
My child/ward _________________________ may be released to the following individual(s):
Name ____________________________ Relationship to Student ____________ Initial _____
Name ____________________________ Relationship to Student ____________ Initial _____
By signing this, I understand that my child/war will be released only to his/her parent(s) or
to the individuals listed above. These individuals MUST provide a legal picture ID when
picking up my child/ward.
Print Name ______________________________________________ Date_________________
Signature _______________________________________________

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